Myocardial injury after noncardiac surgery is defined by elevated postoperative cardiac troponin concentrations that exceed the 99th percentile of the upper reference limit of the assay and are attributable to a presumed ischemic mechanism, with or without concomitant symptoms or signs. Myocardial injury after noncardiac surgery occurs in ≈20% of patients who have major inpatient surgery, and most are asymptomatic. Myocardial injury after noncardiac surgery is independently and strongly associated with both short-term and long-term mortality, even in the absence of clinical symptoms, electrocardiographic changes, or imaging evidence of myocardial ischemia consistent with myocardial infarction. Consequently, surveillance of myocardial injury after noncardiac surgery is warranted in patients at high risk for perioperative cardiovascular complications. This scientific statement provides diagnostic criteria and reviews the epidemiology, pathophysiology, and prognosis of myocardial injury after noncardiac surgery. This scientific statement also presents surveillance strategies and treatment approaches.

中文翻译：

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非心脏手术后心肌损伤患者的诊断和治疗：美国心脏协会的科学声明


非心脏手术后心肌损伤的定义是术后心肌肌钙蛋白浓度升高，超过测定参考上限的第 99 个百分位，并且可归因于推测的缺血机制，有或没有伴随症状或体征。约 20% 的住院大手术患者会出现非心脏手术后的心肌损伤，而且大多数患者无症状。非心脏手术后的心肌损伤与短期和长期死亡率独立且密切相关，即使没有临床症状、心电图变化或与心肌梗死一致的心肌缺血的影像学证据。因此，对于围手术期心血管并发症高风险的患者，有必要监测非心脏手术后的心肌损伤。该科学声明提供了诊断标准，并回顾了非心脏手术后心肌损伤的流行病学、病理生理学和预后。该科学声明还提出了监测策略和治疗方法。